Correlation of high-grade Prostate Imaging Reporting and Data System version 2.1 findings with histopathology results among patients visited the interventional radiology unit at St. Paul's Hospital Millennium Medical College.

Abstract

Abstract Background- Prostate cancer is a common cause of cancer death in men and comes only second after lung cancer. Prostate MRI with the application of PI-RADS v2.1 scoring system helps to stratify patients according to risk and correlate significantly with histopathology results. This study aimed to enhance the diagnostic process of prostate cancer by investigating the correlation between high-grade PI-RADS v2.1 MRI findings and histopathology outcomes following TRUS-guided prostate biopsies. Objectives: To assess the correlation between high-grade Prostate Imaging Reporting and Data System version 2.1 lesions and their MRI findings with histopathology outcomes obtained from biopsies in patients who visited St. Paul’s Hospital Millennium Medical College interventional radiology unit. Methods: A facility-based retrospective patient’s clinical record review study was conducted among patients who were sent to the interventional radiology unit of SPHMMC with high-grade PI-RADS v2.1 MRI reports for TRUS-guided prostate biopsy between January 2023 and April 2024. Data was collected using a structured template, entered into Epi Info v7, and analysed with SPSS v27. Chi-square and Fisher exact tests were used to assess the correlation between high grade PI-RADS v2.1 scores and their MRI findings with histopathology. Results: In our study of 105 patients, a statistically significant correlation was found between certain lesion MRI characteristics and the presence of prostate cancer. Specifically, lesions in the peripheral zone with ill-defined margins, larger size, lenticular or crescentic shape, extraprostatic extensions and high-grade PI-RADS v2.1 score were more likely to be malignant (p-value<0.01). In fact, 94.5% of lesions with a PI-RADS v2.1 score of 5 were cancerous, while 51.5% of lesions with a score of 4 showed malignant characteristics. Conclusion: A significant correlation was observed between high-grade PI-RADS v2.1 scores and the presence of prostate cancer, highlighting the critical role of mpMRI in detecting clinically significant prostate cancer. Integrating mpMRI with clinical and laboratory data can enhance patient care and outcomes. Our institution's performance aligns with published data. Keywords: High-grade Prostate lesions, Prostate Imaging Reporting & Data System version 2.1, St. Paul’s Hospital Millennium Medical College, Interventional radiology